Coughlan J L, Gibson P G, Henry R L
Department of Medicine, John Hunter Hospital, Locked Bag 1, Hunter Region Mail Centre, NSW 2310, Australia.
Thorax. 2001 Mar;56(3):198-204. doi: 10.1136/thorax.56.3.198.
A systematic literature review was conducted to assess the effect of treating reflux oesophagitis on asthma outcomes.
Randomised controlled trials of reflux oesophagitis treatment in adults or children that reported asthma health outcomes were included and assessed in accordance with the standard Cochrane systematic review process. Patients were typically adults with asthma and concurrent symptomatic gastro-oesophageal reflux who received interventions that included pharmacological therapy, conservative management, and surgery. The following outcome measures were assessed: lung function, peak expiratory flow, asthma symptoms, asthma medications, and nocturnal asthma.
From 22 potentially relevant published and unpublished randomised controlled trials, 12 were included. Treatment duration ranged from 1 week to 6 months. Eight trials reported that treatment improved at least one asthma outcome, but these outcomes differed between trials. Overall, treatment of reflux oesophagitis did not consistently improve forced expiratory volume in one second (FEV(1)), peak expiratory flow rate, asthma symptoms, nocturnal asthma symptoms, or use of asthma medications in asthmatic subjects. Significant improvement in wheeze was reported in two studies.
The published literature does not consistently support treatment of reflux oesophagitis as a means of controlling asthma. Further large randomised controlled trials in subjects with a demonstrated temporal relationship between gastro-oesophageal reflux and asthma are needed. These trials should be conducted over at least 6 months to allow adequate time to observe a treatment effect.
进行了一项系统的文献综述，以评估治疗反流性食管炎对哮喘结局的影响。
纳入报告了哮喘健康结局的成人或儿童反流性食管炎治疗的随机对照试验，并按照Cochrane系统评价标准流程进行评估。患者通常为患有哮喘且伴有症状性胃食管反流的成年人，接受的干预措施包括药物治疗、保守治疗和手术。评估了以下结局指标：肺功能、呼气峰值流速、哮喘症状、哮喘药物使用情况和夜间哮喘。
从22项可能相关的已发表和未发表的随机对照试验中，纳入了12项。治疗持续时间从1周至6个月不等。8项试验报告称治疗改善了至少一项哮喘结局，但不同试验的这些结局有所不同。总体而言，反流性食管炎的治疗并未持续改善哮喘患者的一秒用力呼气量（FEV₁）、呼气峰值流速、哮喘症状、夜间哮喘症状或哮喘药物的使用情况。两项研究报告称喘息有显著改善。
已发表的文献并不一致支持将反流性食管炎的治疗作为控制哮喘的一种手段。需要在胃食管反流与哮喘之间存在明确时间关系的受试者中进行进一步的大型随机对照试验。这些试验应至少进行6个月，以便有足够的时间观察治疗效果。
